| Adam "was a wonderfully,
sweet young man," his mother said. He was a high
school athlete and captain of his team, active in his
college fraternity, a good student. He had graduated
from college and started working while studying for
a professional certification exam when something inside
him changed. . . Adam stopped being careful about his
personal appearance. He told his parents he suspected
them of communicating with each other in secret ways,
such as in sign language which he couldn't understand.
He began to hear his mother's voice in his head and
he asked her why she was sending him messages. . . he
was diagnosed with schizophrenia.
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What is schizophrenia?
Schizophrenia, a disease of the brain, is one of the
most disabling and emotionally devastating illnesses
known to man. But because it has been misunderstood
for so long, it has received relatively little attention
and its victims have been undeservingly stigmatized.
Schizophrenia is not a split personality, a rare and
very different disorder. Like cancer and diabetes, schizophrenia
has a biological basis; it is not caused by bad parenting
or personal weakness. Schizophrenia is, in fact, a relatively
common disease, with an estimated one percent to one
and a half percent of the U.S. population being diagnosed
with it over the course of their lives. While there
is no known cure for schizophrenia, it is a very treatable
disease. Most of those afflicted by schizophrenia respond
to drug therapy, and many are able to lead productive
and fulfilling lives.
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What are its symptoms?
Schizophrenia is characterized by a constellation
of distinctive and predictable symptoms. The symptoms
that are most commonly associated with the disease are
called positive symptoms, that denote the presence of
grossly abnormal behavior. These include thought disorder,
delusions, and hallucinations. Thought disorder is the
diminished ability to think clearly and logically. Often
it is manifested by disconnected and nonsensical language
that renders the person with schizophrenia incapable
of participating in conversation, contributing to his
alienation from his family, friends, and society. Delusions
are common among individuals with schizophrenia. An
affected person may believe that he is being conspired
against (called "paranoid delusion"). "Broadcasting"
describes a type of delusion in which the individual
with this illness believes that his thoughts can be
heard by others. Hallucinations can be heard, seen,
or even felt; most often they take the form of voices
heard only by the afflicted person. Such voices may
describe the person's actions, warn him of danger or
tell him what to do. At times the individual may hear
several voices carrying on a conversation. Less obvious
than the "positive symptoms" but equally serious
are the deficit or negative symptoms that represent
the absence of normal behavior. These include flat or
blunted affect (i.e. lack of emotional expression),
apathy, and social withdrawal).
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Who gets it?
While schizophrenia can affect anyone at any point
in life, it is somewhat more common in those persons
who are genetically predisposed to the disease. The
first psychotic episode generally occurs in late adolescence
or early adulthood.
Genetic Link -- The probability of developing schizophrenia
as the offspring of two parents, neither of whom has
the disease, is 1 percent. -- The probability of developing
schizophrenia as the offspring of one parent with the
disease is approximately 13 percent. -- The probability
of developing schizophrenia as the offspring of both
parents with the disease is approximately 35 percent.
Onset by Age -- Three-quarters of persons with schizophrenia
develop the disease between 16 and 25 years of age.
-- Onset is uncommon after age 30, and rare after age
40.
Onset by Sex -- In the 16-25 year old age group, schizophrenia
affects more men than women. -- In the 25-30 year old
group, the incidence is higher in women than in men.
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What is the course
of the disease?
Studies have shown that some persons with schizophrenia
recover completely, and many others improve to the point
where they can live independently, often with the maintenance
of drug therapy. Fortunately, this accounts for the
majority of cases. However, approximately 15 percent
of people with schizophrenia respond only moderately
to medication and require extensive support throughout
their lives, while another 15 percent simply do not
respond to existing treatment. New therapies may offer
hope for the treatment of these most seriously affected
sufferers.
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How is it treated?
Hospitalization is often necessary in cases of acute
schizophrenia. This ensures the safety of the affected
person, while allowing for observation by trained mental
health professionals to determine whether schizophrenia
is the appropriate diagnosis. Hospitalization also allows
for the initiation of medication under close supervision.
Antipsychotic drugs (also called neuroleptics), available
since the 1950s, can dramatically improve the functioning
of people with schizophrenia. Once the most troubling
symptoms are controlled by medication, the person often
does not require hospitalization. Depending on the seriousness
of the disease, the person may utilize day programs,
rehabilitation facilities, and be treated in an outpatient
setting. This allows the psychiatrist to adjust medication
dosages as necessary over the course of the disease.
The person may also need assistance in readjusting to
society once his or her symptoms are controlled. Supportive
counseling or psychotherapy may be appropriate for these
individuals as a source of friendship, encouragement,
and practical advice during this process. Relatives
and friends can also assist in rebuilding the person's
social skills. Such support is very important.
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What can/should I
do if a loved one is sick?
Because an individual with schizophrenia may not be
aware that he is ill, it is often necessary for a friend
or relative to make certain that proper treatment is
sought. A good doctor is critical; it helps to find
one through the recommendation of other families or
healthcare professionals. Once the person is released
from the hospital, families are often left with the
responsibility of ensuring that the person is taking
medication and is continuing to receive whatever other
treatment is necessary. The best way to treat a friend
or relative with schizophrenia is with compassion, understanding,
and support. The person should not be made to feel as
if the disease is his or anybody's fault. As Dr. E.
Fuller Torrey has stated, "People do not cause
schizophrenia; they merely blame each other for doing
so." Learning about the disease and its treatment
will help to avoid the temptation to blame. In addition
to seeking help for the person afflicted with the disease,
loved ones often find mutual support to be invaluable.
AMI/FAMI is a grassroots, self-help organization of
families and friends of people with serious mental illnesses.
Members meet regularly to share practical information
and common experiences.
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Glossary of Mental
Illness Terminology
- Affect: emotional feeling, tone
and mood attached to a thought, including its external
manifestations.
- Bipolar disorder: a periodic, recurrent
mood disorder with intervening periods of complete
normalcy. Not to be confused with schizophrenia.
- Blunted affect: (see flat affect)
- Deficit symptoms: (see negative
symptoms)
- Delusion: fixed, irrational ideas
not shared by others and not responding to reasoned
argument.
- Flat affect: absence of or diminution
in the amount of emotional tone or outward emotional
reaction typically shown under similar circumstances.
- Grandiose delusion: a delusion
in which subject believes himself possessed of great
wealth, intellect, importance, power, etc.
- Hallucination: perceptions that
occur without any external stimulus.
- Inappropriate affect: emotional
tone or outward reaction out of harmony with the idea,
object, or thought accompanying it.
- Manic depressive disorder: (same
as bipolar disorder)
- Negative symptoms: behaviors which
are absent among individuals with schizophrenia but
present among normal individuals.
- Neuroleptic drugs: the standard
drugs currently used to treat the symptoms of schizophrenia.
Positive symptoms: behaviors which are absent among
healthy individuals but present among individuals
with schizophrenia.
- Psychosis: a mental disorder causing
gross distortion or disorganization of a person's
mental capacity, emotional response, and capacity
to recognize reality, communicate, and relate to others
to the degree of interfering with his or her capacity
to cope with the ordinary demands of everyday life.
Schizophrenia: the most common type of psychosis characterized
by a disorder in the thinking processes, such as delusions
and hallucinations, an extensive withdrawal of the
individuals's interest from other people in the outside
world, and the investment of it in his own. Schizophrenia
is now considered to be a group of mental disorders
rather than a single entity.
- Thought disorder: a symptom of
schizophrenia. Clear, goal-directed thinking becomes
increasingly difficult, as shown in a diffuseness
or "woolliness" and circumstantiality of
speech.
- Withdrawal: the process of retreating
from society and relationships with others. Usually
indicated by aloofness, lack of interest in social
activities, and difficulty in communicating with others.
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